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Guy Harling

Publications

Peer-reviewed articles   |    Other publications   |    Presentations

Peer-Reviewed Articles

  1. Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, Barresi LG,Harling G, Bärnighausen TW, Oldenburg CE. Contraceptive use and unplanned pregnancy among female sex workers in Zambia. Contraception, 2017. Accepted for publication.
  2. A description of the very high levels of unplanned pregnancy among female sex workers in Zambian border towns (ZEST study). Highlights the need for contraception support of various kinds.

  3. Harling G, Lima Neto AS, Sousa GS, Machado MMT, Castro MC. Determinants of Tuberculosis transmission and treatment abandonment in Fortaleza, Brazil. BMC Public Health, 2017. 17:508.
    [PubMed]   [Journal (open)]
  4. An analysis of the spatial distribution and risk factors for TB incidence and incomplete treatment in the 5th largest city in Brazil. Incidence rates failed to drop as treatment success rates and DOT coverage fell.

  5. Harling G, Perkins JM, Gómez-Olivé FX, Morris KA, Wagner RG, Montana L, Kabudula C, Bärnighausen TW, Kahn K, Berkman L. Interviewer-driven variability in social network reporting: results from Health and Aging in Africa: a Longitudinal Study of an INDEPTH community (HAALSI) in South Africa. Field Methods, 2017. Accepted for publication.
    [Self-archive (accepted version)]  
  6. Another HAALSI analysis, focused on social network data from the baseline wave of this cohort. We show that even in a one-round survey, the number of important contacts named by respondents fell steadily across the interview period, rebounding only after intensive interviewer retraining. Takeway: Fieldworkers are vital to data collection, they need lots of support and some monitoring.

  7. Manne-Goehler J, Montana L, Gómez-Olivé FX, Rohr J, Harling G, Wagner R, Wade A, Kabudula CW, Tollman S, Berkman LF, Bärnighausen TW, Gaziano TA. The ART advantage: healthcare utilization for diabetes and hypertension in rural South Africa. Journal of Acquired Immune Deficiency Syndromes, 2017. 75(5): 561-567.
    [Journal (gated)]  
  8. A paper from the HAALSI cohort at the Agincourt study site in rural Mpumalanga, South Africa. We highlight that amongst older adults, being on ART is associated with improved control of diabetes and hypertension relative to those HIV-negative or HIV-positive but not on ART. This suggests accessing ART may be protective for other health conditions.

  9. Harling G, Moyo S, McGovern ME, Mabaso M, Marra G, Bärnighausen TW, Rehle T. National South African HIV prevalence estimates robust despite substantial test non-participation. South African Medical Journal, 2017. 107(7): 590-594.
    [Journal (open)]  
  10. We reanalysed the 2012 South African national HIV survey, for which many people had refused to test for HIV. We showed that even allowing for non-random missingness due to unobserved factors (i.e. missingness not at random), the original HIV estimates were reliable. (Technically, the paper used a Selection model that leveraged random assignment of interviewers, who then affected willingness to test, as an instrument.)

  11. Harling G, Onnela J-P. The impact of degree truncation via fixed choice designs on the spread of contagious processes on networks. Network Science, 2017. Accpeted for publication.
    [arXiv preprint]  
  12. We looked at how limiting the amount of data one collects on a social network affects predictions of how epidemics will spread across said networks. Using simulation methods we showed that prediction accuracy fell, with an initial small loss of fidetly followed by a rapid drop-off as more network data was lost. The point of sudden change differed depending on the structure of the network being studied.

  13. Oldenburg CE, Ortblad KF, Chanda M, Mwanda K, Nicodemus W, Sikaundi R, Fullem A, Baresi LG, Harling G, Bärnighausen TW. Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia. BMJ Open, 2017. 7: e014780
    [PubMed]   [Journal (open)]
  14. The protocol paper for a three-arm randomized controlled trial of different methods for providing Zambian FSW with HIV self-tests.

  15. De Neve J-W, Harling G. Offspring schooling associated with increased parental survival in rural KwaZulu-Natal, South Africa. Social Science & Medicine, 2017. 176: 149-157
    [PubMed]   [Journal (open)]
  16. Using a dataset of almost 18,000 adults followed for up to 13 years, we showed that having better-educated children was associated with lower mortality for parents.

  17. Harling G, Wang R, Onnela J-P, De Gruttola V. Leveraging contact network structure in the design of cluster randomized trials. Clinical Trials, 2016. Epub ahead of print.
    [PubMed]   [Journal (open)]   [arXiv preprint]   [Harvard University Biostatistics Working Paper]
  18. We describe a new approach to designing CRTs which starts with those clusters most connected to the rest of the world. Using simulations we show that this significantly increases the speed at which epidemics can be controlled, with only a small drop in power to detect differences across study arms.

  19. Valeri L, Patterson-Lomba O, Gurmu Y, Ablorh A, Bobb J, Townes W, Harling G. Predicting subnational Ebola virus disease epidemic dynamics from sociodemographic indicators. PLoS ONE, 2016; 11(10): e0163544.
    [PubMed]   [Journal (open)]
  20. A collaborative student and postdoc project that emerged from an Ebola Hackathon in late 2014. A combination of epidemic curve-fitting work and Demographic and Health Survey data, used to show how predictions of epidemic spread might be possible using on-the-shelf data.

  21. Oldenburg CE, Bärnighausen T, Tanser F, Iwuji CC, De Gruttola V, Seage GR, Mimiaga MJ, Mayer KH, Pillay D, Harling G. Antiretroviral therapy to prevent HIV acquisition in serodiscordant couples in a hyperendemic community in rural South Africa. Clinical Infectious Diseases, 2016; 63(4): 548-554.
    [PubMed]   [Journal (open)]
  22. An analysis of HIV incidence amongst cohabiting couples in the Africa Centre for Population Health (now AHRI) Demographic Surveillance Area. Key finding: ART is associated with a 77% reduction in hazard of HIV infection, lower than figures from carefully controlled trials.

  23. Harling G, Bärnighausen T. The role of partners’ educational attainment in the association between HIV and education amongst women in seven sub-Saharan African countries. Journal of the International AIDS Society, 2016; 19: 20038.
    [PubMed]   [Journal (open)]
  24. An analysis of 14 Demographic and Health Surveys in 7 countries, looking at how partner's education is associated with womens' HIV status. Finds that even after adjusting for own education, having a partner with much higher or lower education is associated with increased likelihood of being HIV-positive.

  25. Herbst K, Law M, Geldsetzer P, Tanser F, Harling G, Bärnighausen T. Innovations in data collection in health and demographic surveillance systems to establish causal impacts of health policies to improve the HIV treatment cascade. Current Opinion in HIV and AIDS, 2015; 10(6): 483-494.
    [PubMed]   [Journal (open)]
  26. Provides an overview of how novel approaches to data collection in routine surveillance settings can improve data and thus help us better understand how policy affects HIV treatment outcomes. Topics include data collection using: biomarkers; spatial data; social network information; migration events; electronic questionniare methods and mobile phone records. Also discusses linking survey data to administrative records on health, education and welfare services.

  27. Harling G, Tanser F, Mutevedzi T, Bärnighausen T. Assessing the validity of respondents’ reports of their partners’ ages in a rural South African population-based cohort. BMJ Open, 2015. e005638.
    [PubMed]   [Journal (open)]
  28. An analysis of how accurately individuals living in the Africa Centre for Health and Population Studies' Demographic Surveillance Area were able to estimate their partners' age. Conducted by comparing each persons' report of their relationship age-disparity to the age self-report made by their partners. Finds individuals generally are quite close to correct, but with a tendency to lump their relationship age-disparity towards round numbers (5, 10, 15 etc). Shows that accuracy of partner age reports in South Africa is markedly higher than seen elsewhere in Africa.

  29. Harling G, Newell ML, Tanser F, Bärnighausen T. Partner age-disparity and HIV incidence risk for older women in rural South Africa. AIDS & Behavior, 2015. Epub ahead of print.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  30. A partner paper to our earlier analysis of women aged under 30, this paper analyses HIV infection risk for women aged 30-57, based on their most recent relationship's age-disparity. Finds that middle-aged women with same-aged partners were at greatest risk of infection, with risk for a woman with a same-aged partner being double that of one with a partner 10 years older than her.

  31. Harling G, Newell ML, Tanser F, Subramanian SV, Kawachi I, Bärnighausen T. Do age-disparate relationships drive HIV incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. Journal of Acquired Immune Deficiency Syndromes, 2014. 66(4): 443-451.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  32. Provides a longitudinal analysis of the association between the age-difference between 15-29 year old women and their most recent partner, and subsequent HIV infection. In a study population from rural KwaZulu-Natal, South Africa, finds that while age-disparities were moderate (mean of 4 years difference), there was no association between partner age-disparity and HIV.

  33. Harling G, Subramanian SV, Bärnighausen T, Kawachi I. Income inequality and sexually transmitted infections in the United States: Who bears the burden? Social Science & Medicine, 2014. 102: 174-182.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  34. Provides a method for conceptualizing and empirically measuring the three types of effects believed to connect income inequality to health - absolute deprivation (Income), relative deprivation (Yitzhaki index) and structural inequality (Gini coefficient). Highlights how relative deprivation can be conceptualized as the interaction of the other two. Implements the method to examine bacterial STI outcomes in the Add Health study, showing that all but the absolute deprivation effect are confounded by individual race/ethnicity.

  35. Harling G, Castro MC. A spatial analysis of social and economic determinants of tuberculosis in Brazil. Health & Place, 2013; 25C: 56-67.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  36. Provides a descriptive analysis of tuberculosis at the municipality level in Brazil, followed by an analysis of poverty, population density, urbanicity and race as determinants of TB case rates that shows the importance of allowing for spatial autocorrelation.

  37. Oldenburg CE, Bärnighausen T, Harling G, Mimiaga MJ, Mayer KH. Adherence to post-exposure prophylaxis for non-forcible sexual exposure to HIV: a systematic review and meta-analysis. AIDS & Behavior, 2014; 18(2): 217-25.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  38. Reviewing the existing literature on PEP for non-forcible sexual exposure to HIV, the authors find wide variability in methods and resulting levels of adherence. Adherence was notably higher than amongst those experiencing sexual assault. Applicability to pre-exposure prophylaxis is discussed.

  39. Harling G, Subramanian SV, Bärnighausen T, Kawachi I. Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity. Sexually Transmitted Diseases, 2013. 40(7): 575-581.
    [PubMed]   [Journal (gated)] [PubMed Central (open)]
  40. An analysis of socioeconomic gradients of bacterial STI risk in the Add Health cohort up to young adulthood. Finds gradients in risk within racial/ethnic groups, with those for non-White groups being steeper. Also reinforces the finding of large gaps between racial/ethnic groups, even within income strata.

  41. Beck EJ, Avila C, Gerbase S, Harling G, DeLay P. Counting the cost of not costing HIV health facilities accurately: pay now, or pay more later. Pharmacoeconomics, 2012. 30(10): 887-902.
    [PubMed]   [Journal (gated?)]
  42. An overview of the potential risks of relying on cost information from non-local sources in planning national responses to the HIV epidemic. Provides an outline of the data currently available, and how one might go about improving data collection methods in the future.

  43. Beck EJ, Mandalia S, Harling G, Santas XM, Mosure D, DeLay PR. Protecting HIV-information in countries scaling up HIV services. Journal of the International AIDS Society, 2011. 14(1): 6.
    [PubMed]   [Journal (open)] [PubMed Central (open)]
  44. A baseline assessment of national policies in place to protect HIV-related information. Only around a quarter of 77 responding countries reported having guidelines in place; overall protection levels were low.

  45. Müller AD, Jaspan HB, Myer L, Lewis A, Harling G, Bekker LG, Orrell C. Standard measures are inadequate to monitor pediatric adherence in a resource-limited setting. AIDS & Behavior, 2011; 15(2):422-431. [PubMed]   [Journal (open)]
  46. A comparison of various adherence measures to pediatric ART in a primary care facility near Cape Town. None of the alternatives correlated highly with a cap-release based electronic measurement system, but this latter proved far more expensive.

  47. Harling G, Msisha W, Subramanian SV. No association between HIV and intimate partner violence among women in 10 developing countries. PLoS One, 2010. 5(12): e14257.
    [PubMed]   [Journal (open)]
  48. An analysis of the association between history of intimate partner violence and HIV prevalence among women in the 10 Demographic and Health Surveys collecting both sets of data. We found no statistically significant association for each of three measures of violence (physical or sexual, sexual only, both physical and sexual) in any of the surveys.

  49. Beck EJ, Harling G, Gerbase S, DeLay P. The cost of treatment and care for people living with HIV infection: implications of published studies, 1999-2008. Current Opinion in HIV and AIDS, 2010. 5(3): 215-224.
    [PubMed]   [Journal website (gated?)]
  50. A comprehensive review of the literature on costs for HIV treatment and care over the past decade. This study updates and complements an earlier study covering the literature up to 1999.

  51. Harling G, Ehrlich R, Myer L. The social epidemiology of tuberculosis in South Africa: a multilevel analysis. Social Science and Medicine, 2008; 66(2); 492-505.
    [PubMed]   [Journal (gated)] [ Postprint (open; pdf)]
  52. An analysis of the 1998 South African Demographic and Health Survey for social determinants associated with having been diagnosed with tuberculosis. Finds associations with low income and high income inequality, in addition to standard demographic, behavioural and environmental risk factors.

  53. Harling G, Wood R. The evolving cost of HIV in South Africa: changes in healthcare cost with duration on ART for public sector patients. Journal of Acquired Immune Deficiency Syndromes, 2007; 45: 348–354.
    [PubMed]   [Journal (open)]
  54. An analysis of the changes in cost of care for individuals as they begin and maintain antiretroviral treatment. Costs were high immediately prior to, and during the first year of, treatment. Subsequently they declined, largely due to reduced hospital costs.

  55. Harling G, Bekker L-G, Wood R. The cost of an ART clinic. South African Medical Journal, 2007; 97(8): 593-596.
    [PubMed]   [Journal (open; pdf)]
  56. A costing of the construction and maintenance of a stand-alone antiretroviral treatment clinic in a peri-urban setting near Cape Town. More than 60% of total costs were for staff.

  57. Harling G, Orrell C, Wood R. Healthcare utilization of patients accessing an African national antiretroviral treatment program. BMC Health Services Research, 2007; 7: 80.
    [PubMed]   [Journal (open)]
  58. An assessment of how clinic and hospital care changed with time on antiretroviral therapy (ART). AIDS-related opportunistic infections were identified as the greatest driver of utilization, although this subsided after the first year on ART.

  59. Orrell C, Harling G, Lawn S, Kaplan R, McNally M, Bekker L-G, Wood R. Conservation of first line antiretroviral treatment regimen where therapeutic options are limited. Antiviral Therapy, 2007; 12: 83-88.
    [PubMed]   [ Journal (open; pdf)]
  60. An analysis of the causes of switching from first- to second-line antiretroviral therapy in a peri-urban Cape Town cohort. Overall switching was rare, and mainly caused by virological failure or toxicity.

  61. Lawn SD, Myer L, Harling G, Orrell C, Bekker L-G, Wood R. Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for programme evaluation. Clinical Infectious Diseases, 2006; 43: 770-776.
    [PubMed]   [Journal (open)]
  62. An analysis of loss to follow-up (LTFU) and death in a peri-urban Cape Town ART cohort. While LTFU was low, as was late mortality, deaths immediately prior and subsequent to treatment initiation highlighted the need to begin treatment sooner.

  63. Harling G, Wood R, Beck EJ. Efficiency of Interventions in HIV Infection, 1994-2004. Disease Management & Health Outcomes, 2005; 13(6): 371-394.
    [Journal (gated)] [ Postprint (open; pdf)]
  64. A comprehensive review of the literature on the cost-effectiveness of prevention and treatment interventions related to HIV prior to 2005. Includes a copious electronic table with details on all papers reviewed.

Book Chapters

  1. Harling G, Soderstrom L. The contribution of cost-effectiveness analysis. In: Beck EJ, Mays N, Whiteside A, Zuniga JM (Eds). The HIV Pandemic: local and global implications. Oxford: Oxford University Press. 2006.
    [Publisher (gated)]

Letters to the Editor

  1. Oldenburg CE, Bärnighausen T, Tanser F, Iwuji CC, De Gruttola V, Seage III GR, Mimiaga MJ, Mayer KH, Pillay D, Harling G. Reply to Cohen, et al. Clinical Infectious Diseases, 2016. 16(12): 1680.
    [Journal (open)]
  2. A response to Cohen et al.'s letter regarding the Oldenburg et al. paper on the real-world effect of ART within serodiscordant couples.

  3. Harling G, Tsai AC, Subramanian SV. Intimate partner violence and HIV: embracing complexity. Lancet Global Health, 2015; 3(6): e313.
    [Journal (open)]
  4. A letter questioning how a commentary on a recent analysis on intimate partner violence and HIV interpretted the published findings. Argues that the emerging picture from this literature is that some IPV-related risk factors seem not to put women at risk, but women facing multiple or extreme forms of IPV and controlling behaviour are more likely to be HIV-positive.

  5. Harling G, Subramanian SV. The perils of conducting meta-analyses of observational data
    Journal of the International AIDS Society, 2014; 17: 19112 [Journal (open)]
  6. A letter highlighting the potential to hide either confounding or effect-modification of relationships of interest when pooling aggregated data for the purposes of meta-analysis and systematic review. Written in the context of a recent meta-analysis for intimate partner violence and HIV

Reports and Manuals

  1. Manual for costing HIV facilities and services. Geneva: UNAIDS. 2011.
    [UNAIDS (pdf)]
  2. Workbook for the collection of cost information on HIV facilities and services. Geneva: UNAIDS. 2011.
    [UNAIDS (pdf)]

Working Papers

  1. Harling G, Morris KA, Manderson L, Perkins JM, Berkman LF. Social networks and social support among older adults in rural South Africa: Findings from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa.
    [SSRN preprint] [Harvard Centre for Health and Development Studies Working Paper 17(1) (pdf)]
  2. Harling G, Gumede D, Mutevedzi T, McGrath N, Seeley J, Pillay D, Bärnighausen TW, Herbst K. The advantages and disadvantages of self-interviews for sensitive topics: a randomized trial of electronic delivery methods for a sexual behaviour questionnaire in rural South Africa.
    [SSRN preprint]
  3. Grimard F, Harling G. The Impact of Tuberculosis on Economic Growth. August 2004.
    [Working Paper (pdf)]

Theses and Disserations

  1. Harling G. Harvard School of Public Health. Socioeconomic status, socioeconomic context and sexually transmitted infections. May 2013. [ ScD dissertation (pdf)]
  2. Harling G. University of Cape Town The social epidemiology of tuberculosis in South Africa: a multilevel analysis. December 2006.
    [ MPH thesis (pdf)]
  3. Harling G. McGill University. The impact of tuberculosis on economic growth. May 2003.
    [ MA thesis (pdf)]

Oral Presentations

  1. Oldenburg C, Bor J, Tanser F, Harling G, Mutevedzi T, Shahmanesh M, Seage G, De Gruttola V, Mimiaga M, Mayer K, Pillay D, Bärnighausen T. Immediate HIV treatment prevents new infections: causal evidence on the real-world impact of immediate versus deferred ART in rural South Africa. 21st International AIDS Conference, Durban, July 2016.
    [ Slides]   [ Webcast of presentation]
  2. Harling G, Gomez-Olive FX, Morris K, Payne C, Perkins J, Bärnighausen T, Berkman L. Interviewer identity and learning effects as sources of variation in self-reported reported social networks. Sunbelt XXXVI 2016, Long Beach, CA, April 2016.
    [ Handout of slides]
  3. Harling G, Onnela J-P. Degree truncation and its impact on spreading process outcomes. Sunbelt XXXV 2015, Brighton, June 2015.
    [ Handout of slides]
  4. Harling G, Newell ML, Tanser F, Kawachi I, Subramanian SV, Bärnighausen T. Age-Disparate Relationships and HIV Incidence amongst Rural South Africa Women. Conference on Retroviruses and Opportunistic Infections (CROI), Boston, March 2014.
    [ Webcast of presentation]
  5. Harling G, Orrell C, Wood R. The Impact of Delaying Uptake of Second Line Therapy on the Cost-Effectiveness of Antiretroviral Treatment in South Africa. International AIDS Economics Network Meeting, Toronto, August 2006.
    [ Working Paper (pdf)]

Poster Presentations

  1. Harling G, Orrell C, Wood R. National South African HIV prevalence estimates robust despite substantial test non-participation: evidence from the 2012 national population-based survey. Abstract No. WEPEC164. 21st International AIDS Conference, Durban, July 2016.
    [ Poster (pdf)]
  2. Harling G, Tanser F, Mutevedzi T, Bärnighausen T. Assessing the validity of respondents’ reports of their partners’ ages in a rural South African population-based cohort. Population Association of America. San Diego, CA, April 2015.
    [ Poster (pdf)]
  3. Harling G, Wang R, Onnela J-P, De Gruttola V. Leveraging Contact Network Structure for Cluster Randomized Trial Design. Modeling the Spread and Control of Ebola in West Africa. Atlanta, GA, January 2015.
    [ Poster (pdf)]
  4. Harling G, Bärnighausen T. The interplay of own and partner's education on HIV risk in sub-Saharan Africa. Society for Epidemiological Research Annual Conference. Seattle, WA, June 2014.
    [ Poster (pdf)]
  5. Harling G, Bärnighausen T, Subramanian SV, Kawachi I. School Income Inequality and Sexually Transmitted Infections in the United States. Society for Epidemiological Research Annual Conference. Minneapolis, MN, June 2012.
    [ Poster (pdf)]
  6. Harling G, Orrell C, Wood R. Healthcare utilization by a cohort of late-stage HIV-positive patients commencing antiretroviral medication in South Africa. Abstract No. WEPE0085. XVI International AIDS Conference, Toronto, August 2006.
    [ Poster (pdf)]

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